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NSG 3280 Exam 1 QUESTIONS WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
SECTION 1: FLUID & ELECTROLYTE BALANCE (Questions 1–25)
Question 1. A client with heart failure is experiencing fluid overload. Which
nursing interventions are appropriate? (Select all that apply.)
A) Place the client on fluid restrictions
B) Place the client on a sodium-restricted diet
C) Encourage the client to drink 1,500 mL of water daily
D) Provide education on checking food labels for sodium content
Correct Answer: A, B, D
Rationale: Fluid overload commonly results from excess sodium and fluid intake,
which can exacerbate edema and cardiovascular strain. Fluid restrictions and
sodium restrictions are essential components of therapy. Patient education on
reading sodium content in foods helps ensure ongoing adherence. Encouraging
increased fluid intake is contraindicated in fluid overload.
Question 2. A patient with heart failure should avoid which seasoning?
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A) Ginger
B) Bay leaves
C) Nutmeg
D) Onion salt
Correct Answer: D
Rationale: Patients with heart failure are advised to avoid high-sodium seasonings
such as onion salt, garlic salt, and sea salt. Ginger and bay leaves are naturally
sodium-free and safe for daily use, providing flavor without increasing sodium
intake.
Question 3. Lab tests reveal that a patient's sodium level [Na+] is 170 mEq/L.
Which clinical manifestation would the nurse expect to assess?
A) Tented skin turgor and thirst
B) Muscle twitching and tetany
C) Fruity breath and Kussmaul's respirations
D) Muscle weakness and paresthesia
Correct Answer: A
Rationale: Hypernatremia (>145 mEq/L) causes cellular dehydration leading to
thirst and poor skin turgor. Muscle twitching and tetany are more commonly
associated with hypocalcemia. Fruity breath and Kussmaul breathing indicate
metabolic acidosis (e.g., DKA). Muscle weakness and paresthesia are associated
with potassium imbalances.
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Question 4. A client with a very dry mouth, skin, and mucous membranes is
diagnosed with dehydration. Which intervention should the nurse perform
when caring for a client diagnosed with fluid volume deficit?
A) Assessing urinary intake and output
B) Obtaining the client's weight weekly at different times of the day
C) Monitoring arterial blood gas (ABG) results
D) Maintaining I.V. therapy at the keep-vein-open rate
Correct Answer: A
Rationale: Monitoring intake and output is essential to assess fluid balance.
Weekly weights are too infrequent for fluid assessment. ABGs may be useful in
acid-base status but are not the first priority. Keep-vein-open may not provide
enough fluid for dehydration management.
Question 5. A client with tented skin turgor, dry mucous membranes, and
decreased urinary output is under the nurse's care. Which nursing intervention
should be included in the care plan?
A) Administering I.V. and oral fluids
B) Clustering necessary activities throughout the day
C) Assessing color, odor, and amount of sputum
D) Monitoring serum albumin and total protein levels
Correct Answer: A
Rationale: These findings indicate fluid volume deficit/dehydration; fluid
administration is the priority. Clustering activities is appropriate in fatigue but less
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urgent than hydration. Sputum assessment is unrelated. Serum proteins are
longer-term nutrition markers.
Question 6. The normal range for serum potassium is:
A) 2.5–3.5 mEq/L
B) 3.5–5.0 mEq/L
C) 5.0–6.5 mEq/L
D) 6.5–8.0 mEq/L
Correct Answer: B
Rationale: Normal serum potassium is 3.5–5.0 mEq/L. Values below 3.5 indicate
hypokalemia, and values above 5.0 indicate hyperkalemia. Potassium is critical for
cardiac and neuromuscular function.
Question 7. A patient with acute kidney injury has a serum potassium level of
6.8 mEq/L. Which ECG change should the nurse anticipate?
A) Prolonged QT interval
B) Peaked T waves
C) Prominent U waves
D) ST depression
Correct Answer: B
Rationale: Hyperkalemia (>5.0 mEq/L) causes tall, peaked T waves on ECG. Other
findings include widened QRS complex and prolonged PR interval. Prolonged QT
and prominent U waves are associated with hypokalemia.
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NSG 3280 Exam 1 QUESTIONS WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
SECTION 1: FLUID & ELECTROLYTE BALANCE (Questions 1–25)
Question 1. A client with heart failure is experiencing fluid overload. Which
nursing interventions are appropriate? (Select all that apply.)
A) Place the client on fluid restrictions
B) Place the client on a sodium-restricted diet
C) Encourage the client to drink 1,500 mL of water daily
D) Provide education on checking food labels for sodium content
Correct Answer: A, B, D
Rationale: Fluid overload commonly results from excess sodium and fluid intake,
which can exacerbate edema and cardiovascular strain. Fluid restrictions and
sodium restrictions are essential components of therapy. Patient education on
reading sodium content in foods helps ensure ongoing adherence. Encouraging
increased fluid intake is contraindicated in fluid overload.
Question 2. A patient with heart failure should avoid which seasoning?
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,Page 2 of 124
A) Ginger
B) Bay leaves
C) Nutmeg
D) Onion salt
Correct Answer: D
Rationale: Patients with heart failure are advised to avoid high-sodium seasonings
such as onion salt, garlic salt, and sea salt. Ginger and bay leaves are naturally
sodium-free and safe for daily use, providing flavor without increasing sodium
intake.
Question 3. Lab tests reveal that a patient's sodium level [Na+] is 170 mEq/L.
Which clinical manifestation would the nurse expect to assess?
A) Tented skin turgor and thirst
B) Muscle twitching and tetany
C) Fruity breath and Kussmaul's respirations
D) Muscle weakness and paresthesia
Correct Answer: A
Rationale: Hypernatremia (>145 mEq/L) causes cellular dehydration leading to
thirst and poor skin turgor. Muscle twitching and tetany are more commonly
associated with hypocalcemia. Fruity breath and Kussmaul breathing indicate
metabolic acidosis (e.g., DKA). Muscle weakness and paresthesia are associated
with potassium imbalances.
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,Page 3 of 124
Question 4. A client with a very dry mouth, skin, and mucous membranes is
diagnosed with dehydration. Which intervention should the nurse perform
when caring for a client diagnosed with fluid volume deficit?
A) Assessing urinary intake and output
B) Obtaining the client's weight weekly at different times of the day
C) Monitoring arterial blood gas (ABG) results
D) Maintaining I.V. therapy at the keep-vein-open rate
Correct Answer: A
Rationale: Monitoring intake and output is essential to assess fluid balance.
Weekly weights are too infrequent for fluid assessment. ABGs may be useful in
acid-base status but are not the first priority. Keep-vein-open may not provide
enough fluid for dehydration management.
Question 5. A client with tented skin turgor, dry mucous membranes, and
decreased urinary output is under the nurse's care. Which nursing intervention
should be included in the care plan?
A) Administering I.V. and oral fluids
B) Clustering necessary activities throughout the day
C) Assessing color, odor, and amount of sputum
D) Monitoring serum albumin and total protein levels
Correct Answer: A
Rationale: These findings indicate fluid volume deficit/dehydration; fluid
administration is the priority. Clustering activities is appropriate in fatigue but less
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urgent than hydration. Sputum assessment is unrelated. Serum proteins are
longer-term nutrition markers.
Question 6. The normal range for serum potassium is:
A) 2.5–3.5 mEq/L
B) 3.5–5.0 mEq/L
C) 5.0–6.5 mEq/L
D) 6.5–8.0 mEq/L
Correct Answer: B
Rationale: Normal serum potassium is 3.5–5.0 mEq/L. Values below 3.5 indicate
hypokalemia, and values above 5.0 indicate hyperkalemia. Potassium is critical for
cardiac and neuromuscular function.
Question 7. A patient with acute kidney injury has a serum potassium level of
6.8 mEq/L. Which ECG change should the nurse anticipate?
A) Prolonged QT interval
B) Peaked T waves
C) Prominent U waves
D) ST depression
Correct Answer: B
Rationale: Hyperkalemia (>5.0 mEq/L) causes tall, peaked T waves on ECG. Other
findings include widened QRS complex and prolonged PR interval. Prolonged QT
and prominent U waves are associated with hypokalemia.
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